Provider Demographics
NPI:1891430765
Name:SINCLAIR, ASHLIE EXLEY (DNP)
Entity Type:Individual
Prefix:DR
First Name:ASHLIE
Middle Name:EXLEY
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:MISS
Other - First Name:ASHLIE
Other - Middle Name:MARIE
Other - Last Name:EXLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP
Mailing Address - Street 1:60 MEMORIAL MEDICAL PKWY # 2
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-5980
Mailing Address - Country:US
Mailing Address - Phone:386-586-2000
Mailing Address - Fax:
Practice Address - Street 1:60 MEMORIAL MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-5980
Practice Address - Country:US
Practice Address - Phone:386-586-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9260320363LF0000X
FL11020039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL363LFOOOOXMedicaid